Indian Culture Camp
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Registration for IHA STARTALK Hindi Camp
student first name
student last name
date of birth
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Month
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Year
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2021
grade in fall 2021
telephone
gender
male
female
Address
city
state
zip
email
Knowledge of Hindi - Speaking *
Select an option
0
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Knowledge of Hindi - Understanding *
Select an option
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Knowledge of Hindi - Script *
Select an option
0
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Knowledge of Hindi - Reading *
Select an option
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Health-related information, if any
Did you attend IHA OHIO HINDI CAMP last year *
yes
no
Mother's First Name *
Mother's Last Name *
Mother's Cell Number *
Mother's Email *
father's First Name *
father's Last Name *
father's Cell Number *
father's Email *
Emergency Contact Name *
I/We acknowledge that I/we have been advised to make sure that my/our child is physically and mentally fit to participate in various activities of IHA Ohio Hindi Summer Camp.
Note: After filling this form, please send signed Registration Form to: IHA Ohio Hindi Summer Camp, 203 Cheltenham Lane Munroe Falls, Ohio 44262. The registration fee is non-refundable.